FEATURED SEARCH TERM: HIV illicit drug
Retrospective data from an observational cohort of HIV-positive illicit drug users takes a first look at physician factors that contribute to treatment success in this difficult patient population. Among the subjects, most of whom live in an area with high rates of homelessness and poverty, the median time to plasma HIV-1 RNA suppression below 500 copies/mL was more than three times faster for those treated by physicians with the most experience treating HIV in this setting than for those cared for by the least experienced doctors. Less experienced physicians have a preconception that most illicit drug users are not adherent, say the researchers, and may both be less likely to gain their patients' trust and less skilled at managing drug toxicities and other factors that affect success.
RESULT: Physician experience and rates of plasma HIV-2 RNA suppression among illicit drug users: an observational study
BMC Infectious Diseases | Jan 25, 2012 (FREE FULL TEXT)
This problem be even more critical in the US, where access to HIV care is not universal. Johns Hopkins University researchers have a cautionary tale. They're comparing directly-administered versus self-administered antiretroviral therapy among HIV-infected clients of Baltimore-area methadone(Drug information on methadone) clinics. A major reason for exclusions has been treatment drop-outs, most common at the only clinic that does not have on-site HIV care. The team reports difficulty with paperwork and scheduling at that site, where providers are not familiar with HIV, and subjects going there are the ones most concerned about confidentiality.
RESULT: Study design and participant characteristics of a randomized controlled trial of directly administered antiretroviral therapy in opioid treatment programs
BMC Infectious Diseases | Nov 12, 2011 (FREE FULL TEXT)